SALVAGE CHEMO THERAPY WITH CYCLOPHOSPHAMIDE, DOXORUBICIN, AND CISPLATIN (CAP) IN ADVANCED BREAST CANCER

Twenty-one patients with advanced breast cancer (7 premenopausal and 14 postmenopausal women) were treated with a combination of cyclophosphamide, doxorubicin, and cisplatin (CAP). The median age of the patients was 43 years (range 36-61). This therapy was repeated every 3 weeks. Nine patients (group 1) received CAP as primary therapy for metastatic breast cancer, and twelve patients (group 2) received CAP as a second-line therapeutic agent. Of the 12 (57%) patients who responded, six (29%) had complete response (CR). The median disease-free survival (DFS) was 8 months. The response rate was highest for metastases in the pleura (83%) and lymph nodes (81 %), followed by skin (64%), liver and breast (55%). The overall response rate was higher in previously untreated patients than in those previously treated (89% versus 33%, p<O.O I). Complete response rates of 44% and 17%, and median DFS of 10.5 and 3 months respectively, were observed in the two groups of patients. The therapy was well tolerated, myelosuppression being the doselimiting toxicity. The most frequent nonhematological toxicities were nausea, vomiting (100%), mucositis and stomatitis (38%), but these were rarely severe. Total alopecia occurred in only two patients. There were no toxic deaths or cardiotoxicity. Severe anemia occurred more frequently in group 2 patients. The present study suggests a role for CAP combination chemotherapy in the management of advanced breast cancer.